Comparison of prophylactic dexamethasone, metoclopramide, and combination of dexamethasone and metoclopramide for prevention of post-operative nausea and vomiting for major gynaecological surgery in Hawassa university compressive specialized hospital, Ethiopia, 2019: A randomized controlled trial

Abstract Background Postoperative nausea and vomiting is a common postoperative unpleasant and distressful experience among major abdominal gynecological surgery with incidences of up to 54% and 71% vomiting &nausea respectively. PONV is primarily occurs within 24 hours can lead to significant morbidity, unexpected hospital admission of surgical outpatients by reducing patient comfort, delayed discharge from the hospital, and an increase in costs. Objective To compare the effectiveness of dexamethasone, metoclopramide and combination of them in prevention of post-operative nausea and vomiting in patients undergoing gynaecological surgery. Methods Institutional based Prospective randomized control trial study was conducted xxxxxxxx from March, 2018- February, 2019. This study was conducted on female patient age 18-65 years. Data was collected by pretested and self-designed structured questionnaire and analysed by using computer software SPSS version 22.data were evaluated using one way ANOVA test. Categorical data was analysed with the Chi-Square test and P- Value of less than 0.05 was significantly associated with outcome variable. Result Total incidence of PONV during 4-12 h was 25% in the dexamethasone group, 53% in the metoclopramide group, 18.8% in the dexamethasone plus metoclopramide group (p = 0.007). There was significant difference in incidence of nausea at 4-12hour (p=.011) and 12-24hour (p=.043). The overall incidence of PONV was 31.3%, 65.6% &28.1%of dexamethasone, metoclopramide and combination of them respectively which was lower in dexamethasone & combination.(p=.003). Total antiemetic drug over 24hour was significantly lower in the dexamethasone and combination groups than the metoclopramide groups which were, 28.1%, 25% and 62.5% respectively.(p=0.003) Conclusions We conclude that prophylactic Dexamethasone and Dexamethasone plus 10mg Metoclopramide was found more effective in preventing PONV and decreasing the requirement of rescue antiemetic than Metoclopramide & comparable effectiveness between dexamethasone and combination in prophylaxis of PONV.